NUR 4445 Cardiopulmonary System
- Cyanotic
decreased pulmonary blood flow
- Cyanotic conditions
Tetralogy of fallot Transposition of great vessel
- Acyanotic
increased pulmonary blood flow
- Acyanotic conditions
Atrial septal defect Ventricular septal defect Patent ductus arteriosus Coarctation of aorta
- Atrial septal defect,
Opening between L & R atria
Increased volume on R side of heart and increased right atrial and right ventricular size
- Atrial septal defect incidence
10 % of CHD 1 / 3
Twice as common in females
Up to 50% have other heart defects
- Atrial septal defect patho
Acyanotic
Normal pressure on left side of heart ’Blood flows from left to the right across ASD
- Atrial septal defect s/s
Often asymptomatic
-If large ASD, could have poor growth or CHF
Soft systolic murmur & widely split S2 Unaffected by respiratory pattern
- Atrial septal defect diagnosis
Murmur detected Echochardiogram
X-ray - cardiac enlargement, especially R side
- Atrial septal defect treatment
Monitor for spontaneous closure during first 2 years of life Nonsurgical device/patch placement cardiac catheterization Traditional Surgery vertical incision along sternum with defect repaired by stitch closure of patch (Dacron) (may not be done until preschools 2 / 3
- ventricular septal defect
Opening between ventricles
Most common (30%) congenital heart defect
- ventricular septal defect patho
Acyanotic
Blood flow through VSD L’R, recirculates through PA to lungs Left heart enlargement & pulmonary venous congestion Degree of shunting depends on size of defect & child's pulmonary resistance
- ventricular septal defect s/s
Small (80-85%)/Moderate (3-5%)
usually asymptomatic Large
Signs of CHF
-Tachypenic, diaphoretic, fatigues easily, tires with feeding, & FTT.
- ventricular septal defect diagnosis
Loud holosystolic murmurs (beings at the S1 & continues through to S2) ECHO Moderate/large
- / 3